Neurobehavioral disinhibition predicts initiation of substance use in children with prenatal cocaine exposure

Barry M. Lester, Hai Lin, David S. DeGarmo, Philip A. Fisher, Linda L. LaGasse, Todd P. Levine, Seetha Shankaran, Henrietta S. Bada, Charles R. Bauer, Jane A. Hammond, Toni M. Whitaker, Rosemary D. Higgins

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Background: In previous work we (Fisher et al., 2011) examined the emergence of neurobehavioral disinhibition (ND) in adolescents with prenatal substance exposure. We computed ND factor scores at three age points (8/9, 11 and 13/14 years) and found that both prenatal substance exposure and early adversity predicted ND. The purpose of the current study was to determine the association between these ND scores and initiation of substance use between ages 8 and 16 in this cohort as early initiation of substance use has been related to later substance use disorders. Our hypothesis was that prenatal cocaine exposure predisposes the child to ND, which, in turn, is associated with initiation of substance use by age 16. Methods: We studied 386 cocaine exposed and 517 unexposed children followed since birth in a longitudinal study. Five dichotomous variables were computed based on the subject's report of substance use: alcohol only; tobacco only; marijuana only; illicit substances and any substance. Results: Cox proportional hazard regression showed that the 8/9 year ND score was related to initiation of alcohol, tobacco, illicit and any substance use but not marijuana use. The trajectory of ND across the three age periods was related to substance use initiation in all five substance use categories. Prenatal cocaine exposure, although initially related to tobacco, marijuana and illicit substance initiation, was no longer significant with ND scores in the models. Conclusion: Prenatal drug exposure appears to be a risk pathway to ND, which by 8/9 years portends substance use initiation.

Original languageEnglish
Pages (from-to)80-86
Number of pages7
JournalDrug and Alcohol Dependence
Issue number1-2
StatePublished - Nov 1 2012

Bibliographical note

Funding Information:
This work was supported by NIH grants: Supported by the National Institute of Child Health and Human Development (NICHD) Neonatal Research Network and an interinstitute agreement with the National Institute on Drug Abuse (NIDA) through cooperative agreements: U10-DA-024117-01, U10-HD-21385 (to SS), U10-DA-024128-06, U10-HD-2786 (to HSB), U10-DA-024119-01, U10-HD-27904 (to BML), and U10-DA-024118-01, U10-HD-21397 (to CRB); NICHD contract N01-HD-2-3159 (to BML).


  • Neurodevelopmental disinhibition
  • Prenatal cocaine exposure
  • Substance use initiation

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


Dive into the research topics of 'Neurobehavioral disinhibition predicts initiation of substance use in children with prenatal cocaine exposure'. Together they form a unique fingerprint.

Cite this